Fillable ESTABLISHMENT OF DOCTORAL COMMITTEE (Florida Institute of Technology)

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ESTABLISHMENT OF DOCTORAL COMMITTEE (Florida Institute of Technology)

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NAME __________________________________________________________________________________  DATE ______________________________________________
Last First Middle
FIELD OF STUDY _________________________________________________________________________  STUDENT ID NO. ____________________________________
DEGREE PROGRAM ______________________________________________________________________  MAJOR CODE ______________________________________
TITLE OF DISSERTATION ______________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
ESTABLISHMENT OF DOCTORAL COMMITTEE
Major Adviser ____________________________________  Academic Unit_________________________ Signature __________________________________________
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Outside Member __________________________________  Academic Unit_________________________ Signature __________________________________________
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Other Member ___________________________________  Academic Unit_________________________ Signature __________________________________________
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Other Member ___________________________________  Academic Unit_________________________ Signature __________________________________________
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Other Member ___________________________________  Academic Unit_________________________ Signature __________________________________________
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Other Member ___________________________________  Academic Unit_________________________ Signature __________________________________________
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RGR-479-0220
As required by graduate policy (2.3.1), the following advisory committee is established for the student named on this form.
COMMITTEE MEMBER NAME COMMITTEE MEMBER DEPARTMENT COMMITTEE MEMBER SIGNATURE
APPROVALS / CONFIRMATION
APPROVED ______________________________________________________________________________ DATE ______________________________________________
Academic Unit Head
Document Reviewed ______________________________________________________________________ DATE ______________________________________________
Oce of Graduate Programs
APPROVED ______________________________________________________________________________ DATE ______________________________________________
Director, Graduate Programs
STUDENT SIGNATURE ___________________________________________________________________ DATE _______________________________________________
COMMENTS
Florida Institute of Technology § Oce of Graduate Programs § 150 West University Boulevard, Melbourne, FL 32901-6975 § 321-674-8137
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ESTABLISHMENT OF DOCTORAL COMMITTEE (Florida Institute of Technology)

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Completed 29 January 2021

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